Can Chasin’ Association

2008 Family Membership Application

Member Information

First Name:___________________________________

Last Name:___________________________________

Address: _____________________________________

City: ______________ State: _________ Zip: _______

Phone: _____________ e-mail ____________________

Other family members (include birthdates if competing in juniors)

___________________________________________           ___________________________________________________

__________________________________________              ___________________________________________________

Membership Terms and Fees

Family membership fee $55.00.  Membership is effective for the current calendar year. Membership application and fees include one nomination.  You must purchase additional nominations for other family members.  Additional nominations are $15 each.  This membership must be accompanied by the additional nomination form and fees before any points in either the Junior, Open jackpots or $100 Novice Horse Class will accrue.

By applying for this membership, I agree to abide by all rules and regulations set by Can Chasin’ Association. I further agree to release and hold harmless CCA, arena owners, sponsors and any person connected with CCA from losses, damages, or injury to me, my equipment, and/or my animals resulting in my attendance or participation in any CCA event. I also agree to have a current negative coggins on ALL horses in my possession at any CCA event.

Signature ___________________________ Date _____________

Mail to:

Can Chasin' Association

c/o Michelle Henderson

35119 W Hwy 66

Bristow, OK 74010